What is the Best & Least Invasive Procedure for Under-eye Puffiness? My puffiness is not severe, but bothersome.

I am a woman in my early thirties, & I have experienced puffiness under my eyes since I was a little girl. My puffiness is not severe, but bothersome. I am seeking advice as to what the best procedure would be to eliminate the issue. I have been doing research & thought Laser Blepharoplasty might be an option for me. I am interested in the procedure which would be the least invasive, however, actually rid me of the puffiness. The picture posted is of my eyes. Any suggestions? Thank you.

Doctor Answers 6

Eyelid puffiness.

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This puffiness is caused by fat. Eating less salt and pork, etc. can make them better. but you really need a blepharoplasty done thru the inside of the eyelid and fat repositioning. Anything else is hype.

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Treatment of the tear trough

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The least invasive procedure is camouflaging make up. You have a number of options available however the best and least invasive may be mutually exclusive. When I look at your posted photo it is out of focus so it is not clear what is going on. There does appear to be some lower eyelid puffiness but in the absence of a physical examination it is unclear what happens to this with eyeball and eyelid movement. These changes with movement have a bearing on what would be the best treatment option. As you probably already know your options include filler injections to camouflage the edge of the puffy area or removal/destruction of some of the protruding fat or manipulation of the fat so it is not so sharply demarcated from the cheek fat.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Best and Least Invasive Treatment for Under-Eye Puffiness

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Hi Ge,

Fraxel repair fractionated CO2 laser resurfacing and/or Ulthera ultrasound therapy would be the best and least invasive treatments for your lower lid puffiness.  I am afraid that adding hyaluronic acid under your lower lid hollows will result in increased puffiness in your case.  Most importantly, choose your treating physician most carefully.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

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Lower lid issues

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Thanks for the photo.  An exam would be key.  If you have puffiness that is fat, this can be gently removed. If you have depressions that you want improved, they can be filled.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Filler for Eye Puffiness

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Filler, such as Juvederm, may help smooth your lid-cheek junction and make your eyes appear less puffy.  However, care must be taken with the amount injected and the areas of injection to make sure you achieve a natural looking result.  An HA product is a good choice since we can "melt" it away if you do not like the results.  If you use permanent or semi-permanent products you will be in bad shape if you do not like the results.  Surgical procedures such as blepharoplasty would give more long-lasting results but would also be more invasive.  


Good Luck.

Restylane in tear trough improves under eye puffiness.

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This certainly the least invasive approach. It is technically tricky, but when done right, the results are usually gratifying, and they last at least two years.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.